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Cerebral fat embolism syndrome

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Trauma patient with proximal femoral fracture. Not waking up on day 5 off sedation.

Patient Data

Age: 50
Gender: Male

Typical "starfield pattern" of cerebral fat embolism syndrome with bilateral tiny T2 and DWI hyperintense foci within white-matter and grey matter with some bias towards the deep watershed and cortical watershed regions. Several of the foci within the middle cerebellar peduncles and cerebellum show subtle blooming on the gradient sequence likely representing secondary microhemorrhage. 

x-ray

Comminuted and displaced left proximal femoral fracture. 

Case Discussion

A case of cerebral fat embolism syndrome with the typical "starfield pattern" of bilateral tiny T2 and DWI hyperintense foci within white-matter and grey-matter with some bias towards the deep watershed and cortical watershed regions. 

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